Emergence of Multi-Drug Resistant Strains among Bacterial Isolates in a Burn Care Facility

Infection is one of the most common causes of mortality and morbidity following burn injury. The study compared the results obtained in 5 years data (Jan 2008– Dec 2012) with the previous 5 years data (Jan 2003– Dec 2007) from the burn ward to determine the changing patterns and emerging trends of bacterial isolates and also emergence of multi-drug resistant strains among bacterial isolates. From 2008-12, Pseudomonas was found to be most common isolate (37.2%) followed by Staphylococcus aureus (17.5%), Klebsiella (14.6%) and Acinetobacter (12.7%). A constant and significant increase was found in the incidence of Acinetobacter (from 6.1% in 2003–07 to 12.7% in 2008–12) and Klebsiella(from 10.7% in 2003–07 to 14.6% in 2008–12). Most of the gram-negative isolates obtained were found to be MDR. Acinetobacter spp. was the most common MDR organism and has shown little susceptibility to most antibiotics. Imipenem have been very reliable reserve antibiotics throughout the study period for gram negative bacilli with susceptibilities of or near 100%. Isolation of MRSA was 68.8%, but all were sensitive to Vancomycin. Hence in-depth knowledge of the bacteria causing infectious complications and their antibiotic susceptibilities is a prerequisite for treating burn patients. Our study shows frequent shifts in microbial spectrum and their antibiogram, which mandate frequent reassessments of empirical antimicrobial therapy and patient management decisions during treatment of burned patients.